As I am reassessing my OCD, I have to think about the medications I am taking. In that, I can only speak for my own experiences—and that is a big problem. Not a problem in what I can write here per se, but an overall problem with medication for OCD and all mental disorders.
The whole universe of medication quite frankly sucks. For many reasons, and the first of which is that they work to a wildly different effectiveness to every individual. As well, every individual has wildly different side effects. Oh, and these side effects aren’t the minor “who cares” ones you hear in the fast-talking on televisions commercials about the various medications they’re trying to make into consumer products. No, mental health medication side effects can be nasty. Paradoxical reactions, anyone? Yeah. You can take a medication to bring down your anxiety to find out it acts just like 20 cups of coffee drank all at once does1.
The other reason the universe of medication sucks is your gatekeeper to your medication—generally a psychiatrist—will have a varying level of interest in you, personally, getting better. This is not all doctors! I’m not here to bash anyone or any profession as a whole, at least not full-slate. There is a reality though that a lot of doctors do not want to do the work to do what is needed to get one on the right medication.
I’m lucky to have found one that does. After working with many that did not.
That brings us to how one finds the medication (or, mix of medications most often) that works. Here’s where things get really fun.
Roulette! Yeah, a game no gambler would ever recommend2 you actually play in a real casino with your real money is the metaphor for how one gets themselves into the medication that will work for them—a potentially life-changing experience. Great, huh?
Well, the not-so-secret little secret about psychotropic medication is no one really knows how they all work. Oh, they know the chemical compounds, where they bind in the brain, and all that great stuff. And yeah, some are a little more “known” than others, but the word “known” is in quotes because the end result on any individual is absolutely not known. It could do nothing, it could do the opposite, it could do so little it becomes a frustration that brings about more mental health issues, or it could… work.
You just need to spin the wheel and see!
So I am being quite negative it would seem, but I am just speaking from the reality I have seen in myself and many others. I need to stop and mention that I am walking toward what I started this with: medications do work for things like OCD. I actually found this surprising, but when I got my correct mix I realized what was being attacked was not only the OCD itself but things like anxiety, which is very closely tied to OCD.
What is my correct mix? Well, it doesn’t really matter because if you find yourself in need of medication it may be completely different than mine. But I’ll list it anyway, why not?
(I am now opening my spreadsheet which is far too detailed on all of this. I should turn that into an app, make the big bucks as they say3.) So this is me:
Firstly, the Fluvoxamine is the heavy lifter. That is targeted to OCD, and while it doesn’t work for everyone (as I said is the case with all medication in this broad category), it works wonders for me. Absolutely a godsend.
The Buspar is a throwback to when I was trying a different medication every few weeks to get the right mix. Somehow it stuck around, and I think it helps a little with anxiety. One thing to note is once one finds the right mix, hell if they want to change a thing. This isn’t baking, experimentation isn’t considered fun. Especially with someone with OCD.
The Remeron probably does nothing psychologically for me, but it absolutely regulates my sleep. Like a friggin’ champ. Take it, 20 minutes I am out, 8 hours of sleep, I am up. Other than when in manic phases and I decide to get up at 2 am to face the world. Nevertheless, a good sleep medication.
And finally, a narcotic. A narcotic (benzodiazepine) that I long ago promised myself I would not go back on ever again. The withdrawals are horrendous. I am against it, but I was desperate in trying so many medications that this one got put into the mix. And at a high dosage. Funny thing, that Klonopin here, as compared to Xanax years ago, does nothing for me. I feel nothing. So I am tapering off that ugly medication, which itself is fun: because with my OCD I am very prone to overthinking my reactions to medication. Is this working? Is this withdrawal? Is this? Is this? Is this? Is this? Is this? Sigh!
So that is me, but I don’t matter here. Anyone else may have a completely different reaction to any of these medications and the—I don’t know—fifty others that they could potentially look into to work as their mix for OCD (or anything else in the mental illness realm.)
And that is where the whole roulette system comes into play. Why not use another terrible metaphor? I’m going to. You can’t win if you don’t play!
Ok, I cringed too. However, it is the unfortunate reality with psychotropic drugs that you do need to play the game. And thus you need to find a doctor that will move through medications quickly with you to find what works. Do note you can indeed move quickly, it doesn’t take six or so weeks to see if something works. It often takes six or so weeks to see maximum effectiveness, but it should only take a few weeks or less to see if the medication does nothing (quite often the case) or has a paradoxical reaction (oh, you’ll most likely know this the next day.)
Here’s the thing though. And while I try my best to stay away from cliché, I have to say: do not give up. Never give up. Keep trying every medication and mix of medication you can. If your doctor won’t work with you, get another. This is your life and medication can make it better. It absolutely can.
Don’t give up on medication. Ever.
1 Yeah, this happened to me. [BACK]
2 I don’t gamble much, but when I do, since we’re recommending here, play craps. The right way. The odds are very near 1:1 if you play right. [BACK]
3 That was flippant, but now it isn’t. I actually just thought this spreadsheet I am using would make a great app. Awesome. Add that to the calendar as “big project” number five. [BACK]